Provider Demographics
NPI:1669141982
Name:MOUSSALEM, MAJEDA (RD)
Entity type:Individual
Prefix:
First Name:MAJEDA
Middle Name:
Last Name:MOUSSALEM
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 E BROKEN ROCK DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-4616
Mailing Address - Country:US
Mailing Address - Phone:520-351-9037
Mailing Address - Fax:
Practice Address - Street 1:1 LOWER NAVY HILL
Practice Address - Street 2:
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950
Practice Address - Country:US
Practice Address - Phone:670-236-8354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered